Laserfiche WebLink
� � !_ l <br /> CITY OF ORONO <br /> BUILDING PERMIT APPLICATION �� I �,"1 � <br /> FOR NEW STRUCTURES OR ADDITIONS <br /> j��� ;� MailiPO Bo�r66 Permit number: � - ( 2 <br /> 1V <br /> l � Crystal Bay, MN 55323-0066 Date received: � - - 3 <br /> � �� Street Address:' Received by: /"J� <br /> �`,�'F � 2750 Kelley Parkway Plan review fee: ��]7 . <br /> � c,� r �� Orono, MN 55356 12 <br /> ``��st��>�' Totai Fee: o�Dl3-� 'rJ <br /> Main: 952-249-4600 Fax: 952-249-4616 wv�,rw ci o�onomn.us <br /> This application form must be completed in full and all required information must be submitted. <br /> Incomplete applications will be returned. (Please print) <br /> GENERAL INFORMATION: <br /> Job Site Address: 1161 Elmwood Avenue Lots 9 & 18 <br /> Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No <br /> If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be <br /> required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. <br /> CONTRACTOR/APPLICANT INFORMATION: <br /> Name: Colfax Companies <br /> State License# 2 0 6 3 6 3 9 4 Expi ration Date: 0 3/31/2 015 <br /> Phone: (cell) - - (office) -�4 6-4 3 8 0 <br /> Mailing Address: 206 Minnetonka Ave. South City: wayzata, MN ZIP: <br /> Contact Person: Dave Lindstrom Applicant is: Contractor / Homeowner (CircleOne) <br /> Email and/or Fax: dlindstrom@colfaxco.com <br /> PROPERTY OWNER INFORMATION: <br /> Name: Richard C. Sundberg <br /> Phone (day): 612-2 9 8-117 3 <br /> Address: 5125 West St . City: Greenwood ZIP: 55331 <br /> Email and/or Fax sund e�g.ric— @ ail .com <br /> ARCHITECT/ENGINEER INFORMATION: <br /> Name: Terrence Scholz <br /> Phone (day): <br /> Address: 420 Walnut Street North City: Chaska, MN ZIP: 55318 <br /> Email and/or Fax: terrenceascholz@aol .com <br /> PROJECT INFORMATION: Description of pro�ect: <br /> 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& <br /> Water Supply <br /> [�New Construction [�Single Family with [�Residence <br /> ❑Addition attached garage ❑Garage/Accessory Bidg. � Public Sewer <br /> ❑Accessory Building ❑ Single Family with ❑ Deck <br /> ❑ Relocation detached garage ❑ Offce/Commercial ❑ Private Sewer <br /> ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse <br /> ❑ Public ❑ Storage ❑ Public Water <br /> "`Any earth movement may also require ❑Commercial ❑ Other(specify) <br /> MCWD review&permits. ❑ Industrial [�Private Well <br /> Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) <br /> 18202 Minnetonka Blvd <br /> Deephaven,MN 55391 <br /> Phone: 952-471-0590 <br /> Fax: 952-471-0682 <br /> wwvJ.minnehahacreek.or <br /> Estimated Construction Valuation (excluding land) $ 3 � � ��D� <br />